Individual provider Active NPI

Kimmery Cherise Newsom, LMFT, PHD

  • Marriage & Family Therapist
  • Eau Claire, WI
National Provider Identifier
1679891568
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1091 Issued in KS
Practice address
3703 Oakwood Hills Pkwy Ste 100
Eau Claire, WI 54701-4458
Phone
(534) 444-4562
Fax
(534) 444-4563
NPI assigned
May 17, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1091 KS Primary

Addresses

Primary practice location

3703 Oakwood Hills Pkwy Ste 100
Eau Claire, WI 54701-4458

Mailing address

3703 Oakwood Hills Pkwy Ste 100
Eau Claire, WI 54701-4458
Phone (534) 444-4562

Other practice location 1

1115 Westport Dr
Suite D4
Manhattan, KS 66502-2880
Phone (785) 341-8438

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Nystrom & Associates Counseling Wi., S.C. PastSince Apr 20, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1274054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1679891568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 OAKWOOD HILLS PKWY STE 100",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014458",
            "telephone_number": "534-444-4562",
            "fax_number": "534-444-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 OAKWOOD HILLS PKWY STE 100",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547014458",
            "telephone_number": "534-444-4562",
            "fax_number": "534-444-4563"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1115 Westport Dr",
            "address_2": "Suite D4",
            "address_purpose": "LOCATION",
            "city": "Manhattan",
            "state": "KS",
            "postal_code": "665022880",
            "country_code": "US",
            "telephone_number": "785-341-8438",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWSOM",
        "first_name": "KIMMERY",
        "middle_name": "CHERISE",
        "name_prefix": "Dr.",
        "credential": "LMFT, PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-17",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "KS",
            "license": "1091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.